Longitudinal impact of past-year reproductive coercion on contraceptive use dynamics in Sub-Saharan Africa: evidence from eight population-based cohortsResearch in context
Summary: Background: Reproductive coercion (RC) is a type of abuse where a partner intentionally attempts to interfere with fertility through deception or violence, often by manipulating one’s contraceptive use or reproductive decision-making. Cross-sectional studies on the magnitude of RC across s...
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Elsevier
2025-02-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537024006357 |
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| author | Shannon N. Wood Haley L. Thomas Georges Guiella Rosine Mosso Peter Gichangi Simon P.S. Kibira Fredrick Makumbi Pierre Z. Akilimali Funmilola M. OlaOlorun Elizabeth Omoluabi Michele R. Decker |
| author_facet | Shannon N. Wood Haley L. Thomas Georges Guiella Rosine Mosso Peter Gichangi Simon P.S. Kibira Fredrick Makumbi Pierre Z. Akilimali Funmilola M. OlaOlorun Elizabeth Omoluabi Michele R. Decker |
| author_sort | Shannon N. Wood |
| collection | DOAJ |
| description | Summary: Background: Reproductive coercion (RC) is a type of abuse where a partner intentionally attempts to interfere with fertility through deception or violence, often by manipulating one’s contraceptive use or reproductive decision-making. Cross-sectional studies on the magnitude of RC across sub-Saharan Africa have noted associations with contraceptive use. No studies have longitudinally examined RC experiences as related to future contraceptive dynamics, including discontinuation or forgoing use altogether. Methods: Two rounds of longitudinal population-based cohorts across eight sites in sub-Saharan Africa, from November 2020 to January 2023, were used to prospectively examine past-year RC’s impact on future contraceptive dynamics (discontinuation and switching vs. continuation for contraceptive users at baseline; adoption vs. continued non-use for contraceptive non-users at baseline) using bivariate and multivariable multinomial and logistic regression. Findings: Minimal differences in women’s past-year RC experiences were observed over a two-year period. In many settings, RC prevalence decreased. Only in Uganda did past-year RC increase between rounds (15.8% to 17.8%). RC’s impact on contraceptive dynamics over one year differed by setting. In Burkina Faso, women with past-year RC had a three-fold increased risk of discontinuing contraception, as compared to continuing (RRR = 2.63; 95% CI = 1.28–5.42; p<0.01). In Uganda, past-year RC was marginally associated with reduced odds of contraceptive adoption, compared to continued non-use (p<0.1). Interpretation: In this first longitudinal study of RC, trajectories varied across settings, as did RC’s impact on contraception, affirming the importance of context. Future work should clarify RC trajectories and drivers thereof. Providers must be aware of RC leading to potential discontinuation. Contraceptive provision must be flexible and reflect women’s life circumstances, including partner dynamics. Funding: This work was supported, in whole, by the Bill & Melinda Gates Foundation [INV-046501 and INV-009639]. Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-02-01 |
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| series | EClinicalMedicine |
| spelling | doaj-art-864d1f0652a345b581759d69e654ee542025-01-11T06:41:51ZengElsevierEClinicalMedicine2589-53702025-02-0180103056Longitudinal impact of past-year reproductive coercion on contraceptive use dynamics in Sub-Saharan Africa: evidence from eight population-based cohortsResearch in contextShannon N. Wood0Haley L. Thomas1Georges Guiella2Rosine Mosso3Peter Gichangi4Simon P.S. Kibira5Fredrick Makumbi6Pierre Z. Akilimali7Funmilola M. OlaOlorun8Elizabeth Omoluabi9Michele R. Decker10Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Corresponding author. 615 N Wolfe St, W4511, Baltimore, MD 21205, USA.Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USAInstitut Supérieur des Sciences de la Population (ISSP/University of Ouagadougou), Ouagadougou, Burkina FasoEcole Nationale Superieure de Statistique et Appliquee d’Abidjan (ENSEA), Abidjan, Cote d’IvoireTechnical University of Mombasa, Mombasa, Kenya; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, BelgiumMakerere University School of Public Health, Kampala, UgandaMakerere University School of Public Health, Kampala, UgandaKinshasa School of Public Health, Kinshasa, Democratic Republic of the CongoCollege of Medicine, University of Ibadan, Ibadan, NigeriaFaculty of Natural Sciences, University of the Western Cape, Cape Town, South AfricaDepartment of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Johns Hopkins School of Nursing, Baltimore, USASummary: Background: Reproductive coercion (RC) is a type of abuse where a partner intentionally attempts to interfere with fertility through deception or violence, often by manipulating one’s contraceptive use or reproductive decision-making. Cross-sectional studies on the magnitude of RC across sub-Saharan Africa have noted associations with contraceptive use. No studies have longitudinally examined RC experiences as related to future contraceptive dynamics, including discontinuation or forgoing use altogether. Methods: Two rounds of longitudinal population-based cohorts across eight sites in sub-Saharan Africa, from November 2020 to January 2023, were used to prospectively examine past-year RC’s impact on future contraceptive dynamics (discontinuation and switching vs. continuation for contraceptive users at baseline; adoption vs. continued non-use for contraceptive non-users at baseline) using bivariate and multivariable multinomial and logistic regression. Findings: Minimal differences in women’s past-year RC experiences were observed over a two-year period. In many settings, RC prevalence decreased. Only in Uganda did past-year RC increase between rounds (15.8% to 17.8%). RC’s impact on contraceptive dynamics over one year differed by setting. In Burkina Faso, women with past-year RC had a three-fold increased risk of discontinuing contraception, as compared to continuing (RRR = 2.63; 95% CI = 1.28–5.42; p<0.01). In Uganda, past-year RC was marginally associated with reduced odds of contraceptive adoption, compared to continued non-use (p<0.1). Interpretation: In this first longitudinal study of RC, trajectories varied across settings, as did RC’s impact on contraception, affirming the importance of context. Future work should clarify RC trajectories and drivers thereof. Providers must be aware of RC leading to potential discontinuation. Contraceptive provision must be flexible and reflect women’s life circumstances, including partner dynamics. Funding: This work was supported, in whole, by the Bill & Melinda Gates Foundation [INV-046501 and INV-009639]. Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission.http://www.sciencedirect.com/science/article/pii/S2589537024006357Reproductive coercionContraceptionReproductive healthSub-Saharan AfricaLongitudinal |
| spellingShingle | Shannon N. Wood Haley L. Thomas Georges Guiella Rosine Mosso Peter Gichangi Simon P.S. Kibira Fredrick Makumbi Pierre Z. Akilimali Funmilola M. OlaOlorun Elizabeth Omoluabi Michele R. Decker Longitudinal impact of past-year reproductive coercion on contraceptive use dynamics in Sub-Saharan Africa: evidence from eight population-based cohortsResearch in context EClinicalMedicine Reproductive coercion Contraception Reproductive health Sub-Saharan Africa Longitudinal |
| title | Longitudinal impact of past-year reproductive coercion on contraceptive use dynamics in Sub-Saharan Africa: evidence from eight population-based cohortsResearch in context |
| title_full | Longitudinal impact of past-year reproductive coercion on contraceptive use dynamics in Sub-Saharan Africa: evidence from eight population-based cohortsResearch in context |
| title_fullStr | Longitudinal impact of past-year reproductive coercion on contraceptive use dynamics in Sub-Saharan Africa: evidence from eight population-based cohortsResearch in context |
| title_full_unstemmed | Longitudinal impact of past-year reproductive coercion on contraceptive use dynamics in Sub-Saharan Africa: evidence from eight population-based cohortsResearch in context |
| title_short | Longitudinal impact of past-year reproductive coercion on contraceptive use dynamics in Sub-Saharan Africa: evidence from eight population-based cohortsResearch in context |
| title_sort | longitudinal impact of past year reproductive coercion on contraceptive use dynamics in sub saharan africa evidence from eight population based cohortsresearch in context |
| topic | Reproductive coercion Contraception Reproductive health Sub-Saharan Africa Longitudinal |
| url | http://www.sciencedirect.com/science/article/pii/S2589537024006357 |
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